Specific Aims  Revise the REMAS intervention to be more culturally relevant to African American and Hispanic Men (Phase 1).  Conduct a pilot feasibility trial of the revised REMAS in four CTN CTPs in which there is a high percentage of African American or Hispanic clients (Phase 2). Background  “Real Men Are Safe” is a CDC recognized, evidenced based HIV prevention intervention targeting men in substance abuse treatment (see Figures 1 & 2).  However, Real Men Are Safe, was not as effective with non-white men as white men (See Figure 3). Delphi Process Procedures 1)In round 1 of the Delphi Process expert panel members reviewed and rated all the modules from Real Men Are Safe and similar themed modules from 4 HIV prevention interventions culturally tailored to either African Americans or Hispanics. REMAS Content Areas Culturally Tailored Interventions Getting Started / Session Review Nia: HIV/STD Information (African American heterosexual men) Risk Self Assessment- Risk Reduction Motivation d-up Healthy Options (African American MSM) Condom Use Skills Overcoming Barriers to Condom Use Many Men. Many Voices Prevention Planning (African American MSM) Sex without Drugs Coping with Sexual Dysfunction Cuídate Relationships and Sexual Norms (Hispanic adolescents) Safe Sex Communications Summary 2)Panel members rated each module on a 1 (insensitive) to 5 (very sensitive) scale on 4 dimensions. 1. Use of Language/Expressions of the Target Group (African American or Hispanic). 2. Activities that Enhance Ethnic Identity. 3. Consistent with Norms, Knowledge, Cultural Values of Target Group. 4. Understands Social Context that Surrounds the Behavior and Living Situation of Target Group. 3)Panel members also provided specific suggestions of revisions for REMAS to increase it’s cultural sensitivity. 4)Following Round 1 REMAS is revised in response to ratings & expert recommendations. For Round 2 the revised version of REMAS is reviewed and rated by the expert panel. 5)Following Round 2 a final version or REMAS-CA (culturally adapted ) is completed and readied for pilot testing in 4 NIDA CTN community treatment programs. Conclusions ♦The Delphi Process was successfully utilized to revise the Real Men Are Safe HIV prevention intervention to make it more sensitive to culturally diverse populations of African American, White and Hispanic men in substance abuse treatment. ♦Although the quantitative ratings and qualitative suggestions were for the most part consistent with each other, the qualitative feedback was utilized more extensively in making revisions to REMAS. ♦The effectiveness of REMAS-CA at decreasing high risk sexual behavior of African American and Hispanic men in substance abuse treatment is currently undergoing pilot testing. Acknowledgements This study was supported by National Institute on Drug Abuse (NIDA) grants RC1 DA (Donald Calsyn, PI) and U10 DA13714 (Dennis Donovan, PI) The authors wish to thank the 9 expert panel members for their participation in the Delphi Process, and the four NIDA Clinical Trials Network community treatment programs and their staffs engaged in Phase 2. Culturally Tailoring the Real Men Are Safe HIV Prevention Intervention Mary A Hatch-Maillette, Ph.D. 1,2, Donald A Calsyn, Ph.D. 1,2, A. Kathleen Burlew, Ph.D. 4, Jerika Wilson, B.S. 4, Blair Beadnell 1,3, Lynette Wright 1 1 Alcohol & Drug Abuse Institute, 2 Department of Psychiatry & Behavioral Sciences, 3 School of Social Work, University of Washington, Seattle, WA; 4 University of Cincinnati, 5 The Crossroads Center, Cincinnati, OH Real Men are Safe-CA Revisions by Session Session 1 Session 2 Session 3 HIV/AIDS Update: HIV/AIDS Update: Sex without Drugs. Can It Happen ? Identifying Risks Planning Prevention Is It Pleasurable? I. Group Introductions. Goals and Guidelines I. Welcome, redo introductions I. Welcome, redo introductions II. HIV Risky Behaviors Exercise II. Review Drug Use Practices II. Building Skills for Making Safer Sex III. HIV/AIDS Update – Myths & Facts & Safe Sex Hierarchies Decisions: Movie Clips IV. Sexually Transmitted Infections III. Male Condom Demonstration III. Experience with combining sex & drugs V. Revisit Risky Behaviors Exercise IV. Male Condom Practice Enhancements/Impairments VI. Talking Circle V. Female Condom Demonstration IV. Enhancing sex without drugs VI. Barriers to Condom Use V. Talking Circle VII. Talking Circle Session 4 Session 5 Legend Intimate Relationships Beyond the Pick Up Line I. Welcome, redo introductions I. Welcome, redo introductionsBlue text=no or little change II. Who’s got the Power? II. Communicating About Safe Sex: Talk Tools Who’s Showin’ the Love? III. Responding to Excuses for Not Using Condoms Brown text=significant change III. Culture values & intimate relationships IV. Responding to come-ons for sex under the influence IV. Ideal man / ideal woman brainstorming V. Practicing TALK Tools: Role Plays Purple text= new material or very V. Changing Social Norms VI. Personalizing Commitment to Sexual Safety substantial change VI. Talking Circle VII. Talking Circle ES=.213 Intervention by Time by Complete p<.001 ES=.337 t Intervention =1.99, p<.05, Repeated Measures Logistic Regression